Homestead_White (3)CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT /STANDARD DEDUCTION
Stala Forth 5473 (R7 / 54M
Preemnlood by III Deparbrient of Loral Government Finance
INSTRUC7701VS: See rwam side for Ming instructions
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I (We) qA&4kAa. b%.) nou-) certify that on the 1 st day of March, 20_
I (We) occupied as our principal place of residence the following described real prop" for which a Hornestead Property Tat Credit is hereby claimed:
'I
l(We)owned ❑ Are buying under contract
WMTOR
JF Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is II under a contact
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ONMCTFtECOFtDED 71W
If buying m metracl, Fee Simple ownaes rearm,
Rixorder't 01I where cordrad in rewrded Record number Page
PROPERTYDESCRI
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Tominstap
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ASSESSOR
p..4 nurturer
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finmNatRIMS, ere, 1� 1,610 1, 640
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property ❑ Mobil. Fine (LC. 61.1 -7)
ff arty portion of the msW diet irrrnedialely surroundsdel
is used toproduosincon describe the use and portion
of the property L4*md to prod" incorne- qly6
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20 _ Pay 20 _
Lesser of 112 Hornestand
Vatuatmon or S35,000
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Assissm. 41
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Land not exceeding I (one) acre immediately
wbvi'Mq 'M I , , ,
surrouriding residential irriprovernents.
Other land
(2)
Total land (Pure 1 plus Eno 2)
(3)
Dwelling
(4)
Residential inilonyvernents a Annually
..4
Assessed Mobile I Manufactured Flonne
Garage
(5)
'v, V'j;tP4
jt
Other unpromements
(6)
Tdal ffriprovernents (roe 4 through fine 6)
(7)
Trial value (thm 3 phis fine 7)
(8)
1 hereby certify the above is true, correct. and
corrviets.
Signature ofAssessrt
Data Signed
win" action - signak" of Axilitor
Date signed
20 _ Pay 20 _
Lesser of 112 Hornestand
Vatuatmon or S35,000
r.
STATE FOrM!3 s IR:/W.) TRL5tJtl FORM 7f1A
MI ROVED BY 511TE Bn1AU OF.MYTtNr3,9v PRIAA®FD BY THE DtPARTMEYTCFLOCcAL CAK'ER\MQ.l FP:A\'CE M.-I.1-24I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more internist than ever for homestead d fraud.Ilomestead fraud cause higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Ikpanntent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
White, Kendra
500 N'Warnock
Princeton IN 47670
193
Kendra White
R7 Box 184 State Parcel Number Legal Description
PATOKA IN 47666-9225
26-05-20-300-002.313-018 010-02313-00 PT SW FR 201 10 1.9149
_—_ _ —t n set r set set n t un t u t t t set t nt t u __ - _ _ __ _AC C 1
_ _ --_ _ __
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
ICen Rn- L 3 W1--; r T2-
g Address(number and street,city,state,and ZIP code) El Same as property address
oh
BOY as Perov.- zla. y-1uuu a1 E 350 N
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
—— Social Security Number(last 5 digits) Driver's specify s License/State ID Number (last 5 digits) Other(please ecify in Part 4 below)
• PART 3:CERTIFICA ION•• • • • "s - - —--
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
PART 4:ADDITIONAL INFORMATION
•